Organization
C-DENTAL X-RAY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEROME N PECK DLXT (CEO)
(650) 207-6209
Entity
Organization
Contact information
Practice address
1050 NORTHGATE DR, STE. 110, SAN RAFAEL, CA 94903-2526
(415) 472-1323
Mailing address
450 SUTTER ST, STE. 1542, SAN FRANCISCO, CA 94108-4206
(415) 421-1389
Taxonomy
Speciality
Code
Description
License number
State
292200000X
Dental Laboratory
Primary
RHP00053519
CA
Other
Enumeration date
08/18/2015
Last updated
08/18/2015
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